A surgery happens once. Glp1s are forever.

$25k today or $15k/yr for 20 years?

GLP1s don't or shouldn't cost $1K+/month.

Gastric bypass surgery happens once. Many bypass patients require lifelong prescription nutritional supplements and all require lifelong lab monitoring.

Ulcer risks increase severalfold.

High risk of hernias, osteoporosis and complications thereof.

It's not just surgery and no immediate cost. But then again, any of those issues are options for denial, so...